Asthma Attack

What is an Asthma Attack

Acute bronchospasm caused by asthma is also referred to as an asthma attack. Bronchospasm means that the air passages become narrowed or “tight,” which limits the amount of oxygen that can get into the lungs.

The narrowing is caused by inflammation and tightening of the muscles in the air tubes (bronchi) in the lungs. Excessive mucus is also produced, which narrows the airways more. This can cause trouble breathing, coughing, and loud breathing (wheezing).

What are the causes?

Possible triggers include:

  • Animal dander from the skin, hair, or feathers of animals.
  • Dust mites contained in house dust.
  • Cockroaches.
  • Pollen from trees or grass.
  • Mold.
  • Cigarette or tobacco smoke.
  • Air pollutants such as dust, household cleaners, hair sprays, aerosol sprays, paint fumes, strong chemicals, or strong odors.
  • Cold air or weather changes. Cold air may trigger inflammation. Winds increase molds and pollens in the air.
  • Strong emotions such as crying or laughing hard.
  • Stress.
  • Certain medicines, such as aspirin or beta-blockers.
  • Sulfites in foods and drinks, such as dried fruits and wine.
  • Infections or inflammatory conditions, such as a flu, a cold, pneumonia, or inflammation of the nasal membranes (rhinitis).
  • Gastroesophageal reflux disease (GERD). GERD is a condition in which stomach acid backs up into your esophagus, which can irritate nearby airway structures.
  • Exercise or activity that requires a lot of energy.

What are the signs or symptoms?

Symptoms of this condition include:

  • Wheezing. This may sound like whistling while breathing. This may be more noticeable at night.
  • Excessive coughing, particularly at night.
  • Chest tightness or pain.
  • Shortness of breath.
  • Feeling like you cannot get enough air no matter how hard you try (air hunger).

How is this diagnosed?

This condition may be diagnosed based on:

  • Your medical history.
  • Your symptoms.
  • A physical exam.
  • Tests to check for other causes of your symptoms or other conditions that may have triggered your asthma attack. These tests may include:
    • Chest X-ray.
    • Blood tests.
    • Specialized tests to assess lung function, such as breathing into a device that measures how much air you inhale and exhale (spirometry).

How is this treated?

The goal of treatment is to open the airways in your lungs and reduce inflammation. Most asthma attacks are treated with medicines that you inhale through a hand-held inhaler (metered dose inhaler, MDI) or a device that turns liquid medicine into a mist that you inhale (nebulizer). Medicines may include:

  • Quick relief or rescue medicines that relax the muscles of the bronchi. These medicines include bronchodilators, such as albuterol.
  • Controller medicines, such as inhaled corticosteroids. These are long-acting medicines that are used for daily asthma maintenance.

If you have a moderate or severe asthma attack, you may be treated with steroid medicines by mouth or through an IV injection at the hospital. Steroid medicines reduce inflammation in your lungs. Depending on the severity of your attack, you may need oxygen therapy to help you breathe.

If your asthma attack was caused by a bacterial infection, such as pneumonia, you will be given antibiotic medicines.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider. Keep your medicines up-to-date and available.
  • If you are more than 24 weeks pregnant and you are prescribed any new medicines, tell your obstetrician about those medicines.
  • If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.

Avoiding triggers

  • Keep track of things that trigger your asthma attacks or cause you to have breathing problems, and avoid exposure to these triggers.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Avoid secondhand smoke.
  • Avoid strong smells, such as perfumes, aerosols, and cleaning solvents.

When pollen or air pollution is bad, keep windows closed and use an air conditioner or go to places with air conditioning.

Asthma action plan

  • Work with your health care provider to make a written plan for managing and treating your asthma attacks (asthma action plan). This plan should include:
    • A list of your asthma triggers and how to avoid them.
    • Information about when your medicines should be taken and when their dosage should be changed.
    • Instructions about using a device called a peak flow meter to monitor your condition. A peak flow meter measures how well your lungs are working and measures how severe your asthma is at a given time. Your “personal best” is the highest peak flow rate you can reach when you feel good and have no asthma symptoms.

General instructions

  • Avoid excessive exercise or activity until your asthma attack resolves. Ask your health care provider what activities are safe for you and when you can return to your normal activities.
  • Stay up to date on all vaccinations recommended by your health care provider, such as flu and pneumonia vaccines.
  • Drink enough fluid to keep your urine clear or pale yellow. Staying hydrated helps keep mucus in your lungs thin so it can be coughed up easily.
  • If you drink caffeine, do so in moderation.
  • Do notuse alcohol until you have recovered.
  • Keep all follow-up visits as told by your health care provider. This is important. Asthma requires careful medical care, and you and your health care provider can work together to reduce the likelihood of future attacks.

Contact a health care provider if:

  • Your peak flow reading is still at 50–79% of your personal best after you have followed your action plan for 1 hour. This is in the yellow zone, which means “caution.”
  • You need to use a reliever medicine more than 2–3 times a week.
  • Your medicines are causing side effects, such as:
    • Rash.
    • Itching.
    • Swelling.
    • Trouble breathing.
  • Your symptoms do not improve after 48 hours.
  • You cough up mucus (sputum) that is thicker than usual.
  • You have a fever.
  • You need to use your medicines much more frequently than normal.

Get help right away if:

  • Your peak flow reading is less than 50% of your personal best. This is in the red zone, which means “danger.”
  • You have severe trouble breathing.
  • You develop chest pain or discomfort.
  • Your medicines no longer seem to be helping.
  • You vomit.
  • You cannot eat or drink without vomiting.
  • You are coughing up yellow, green, brown, or bloody mucus.
  • You have a fever and your symptoms suddenly get worse.
  • You have trouble swallowing.
  • You feel very tired, and breathing becomes tiring.

Summary

  • Acute bronchospasm caused by asthma is also referred to as an asthma attack.
  • Bronchospasm is caused by narrowing or tightness in air passages, which causes shortness of breath, coughing, and loud breathing (wheezing).
  • Many things can trigger an asthma attack, such as allergens, weather changes, exercise, smoke, and other fumes.
  • Treatment for an asthma attack may include inhaled rescue medicines for immediate relief, as well as the use of maintenance therapy.
  • Get help right away if you have worsening shortness of breath, chest pain, or fever, or if your home medicines are no longer helping with your symptoms.

Asthma Attack Prevention, Adult

Although you may not be able to control the fact that you have asthma, you can take actions to prevent episodes of asthma (asthma attacks). These actions include:

  • Creating a written plan for managing and treating your asthma attacks (asthma action plan).
  • Monitoring your asthma.
  • Avoiding things that can irritate your airways or make your asthma symptoms worse (asthma triggers).
  • Taking your medicines as directed.
  • Acting quickly if you have signs or symptoms of an asthma attack.

What are some ways to prevent an asthma attack?

Create a plan

Work with your health care provider to create an asthma action plan. This plan should include:

  • A list of your asthma triggers and how to avoid them.
  • A list of symptoms that you experience during an asthma attack.
  • Information about when to take medicine and how much medicine to take.
  • Information to help you understand your peak flow measurements.
  • Contact information for your health care providers.
  • Daily actions that you can take to control asthma.

Monitor your asthma

To monitor your asthma:

  • Use your peak flow meter every morning and every evening for 2–3 weeks. Record the results in a journal. A drop in your peak flow numbers on one or more days may mean that you are starting to have an asthma attack, even if you are not having symptoms.
  • When you have asthma symptoms, write them down in a journal.

Avoid asthma triggers

Work with your health care provider to find out what your asthma triggers are. This can be done by:

  • Being tested for allergies.
  • Keeping a journal that notes when asthma attacks occur and what may have contributed to them.
  • Asking your health care provider whether other medical conditions make your asthma worse.

Common asthma triggers include:

  • Dust.
  • Smoke. This includes campfire smoke and secondhand smoke from tobacco products.
  • Pet dander.
  • Trees, grasses or pollens.
  • Very cold, dry, or humid air.
  • Mold.
  • Foods that contain high amounts of sulfites.
  • Strong smells.
  • Engine exhaust and air pollution.
  • Aerosol sprays and fumes from household cleaners.
  • Household pests and their droppings, including dust mites and cockroaches.
  • Certain medicines, including NSAIDs.

Once you have determined your asthma triggers, take steps to avoid them. Depending on your triggers, you may be able to reduce the chance of an asthma attack by:

  • Keeping your home clean. Have someone dust and vacuum your home for you 1 or 2 times a week. If possible, have them use a high-efficiency particulate arrestance (HEPA) vacuum.
  • Washing your sheets weekly in hot water.
  • Using allergy-proof mattress covers and casings on your bed.
  • Keeping pets out of your home.
  • Taking care of mold and water problems in your home.
  • Avoiding areas where people smoke.
  • Avoiding using strong perfumes or odor sprays.
  • Avoid spending a lot of time outdoors when pollen counts are high and on very windy days.
  • Talking with your health care provider before stopping or starting any new medicines.

Medicines

Take over-the-counter and prescription medicines only as told by your health care provider. Many asthma attacks can be prevented by carefully following your medicine schedule. Taking your medicines correctly is especially important when you cannot avoid certain asthma triggers. Even if you are doing well, do notstop taking your medicine anddo nottake less medicine.

Act quickly

If an asthma attack happens, acting quickly can decrease how severe it is and how long it lasts. Take these actions:

  • Pay attention to your symptoms. If you are coughing, wheezing, or having difficulty breathing, do not wait to see if your symptoms go away on their own. Follow your asthma action plan.
  • If you have followed your asthma action plan and your symptoms are not improving, call your health care provider or seek immediate medical care at the nearest hospital.

It is important to write down how often you need to use your fast-acting rescue inhaler. You can track how often you use an inhaler in your journal. If you are using your rescue inhaler more often, it may mean that your asthma is not under control. Adjusting your asthma treatment plan may help you to prevent future asthma attacks and help you to gain better control of your condition.

How can I prevent an asthma attack when I exercise?

Exercise is a common asthma trigger. To prevent asthma attacks during exercise:

  • Follow advice from your health care provider about whether you should use your fast-acting inhaler before exercising. Many people with asthma experience exercise-induced bronchoconstriction (EIB). This condition often worsens during vigorous exercise in cold, humid, or dry environments. Usually, people with EIB can stay very active by using a fast-acting inhaler before exercising.
  • Avoid exercising outdoors in very cold or humid weather.
  • Avoid exercising outdoors when pollen counts are high.
  • Warm up and cool down when exercising.
  • Stop exercising right away if asthma symptoms start.

Consider taking part in exercises that are less likely to cause asthma symptoms such as:

  • Indoor swimming.
  • Biking.
  • Walking.
  • Hiking.
  • Playing football.

Asthma Attack Prevention, Pediatric

Although you may not be able to control the fact that your child has asthma, you can take actions to help prevent your child from experiencing episodes of asthma (asthma attacks). These actions include:

·         Creating a written plan for managing and treating asthma attacks (asthma action plan).

·         Having your child avoid things that can irritate the airways or make asthma symptoms worse (asthma triggers).

·         Making sure your child takes medicines as directed.

·         Monitoring your child’s asthma.

·         Acting quickly if your child has signs or symptoms of an asthma attack.

What are some ways I can protect my child from an asthma attack?

Create a plan

Work with your child’s health care provider to create an asthma action plan. This plan should include:

·         A list of your child’s asthma triggers and how to avoid them.

·         A list of symptoms that your child experiences during an asthma attack.

·         Information about when to give or adjust medicine and how much medicine to give.

·         Information to help you understand your child’s peak flow measurements.

·         Contact information for your child’s health care providers.

·         Daily actions that your child can take to control her or his asthma.

Avoid asthma triggers

Work with your child’s health care provider to find out what your child’s asthma triggers are. This can be done by:

·         Having your child tested for certain allergies.

·         Keeping a journal that notes when asthma attacks occur and what may have contributed to them.

·         Asking your child’s health care provider whether other medical conditions make your child’s asthma worse.

Common childhood triggers include:

·         Pollen, mold, or weeds.

·         Dust or mold.

·         Pet hair or dander.

·         Smoke. This includes campfire smoke and secondhand smoke from tobacco products.

·         Strong perfumes or odors.

·         Extreme cold, heat, or humidity.

·         Running around.

·         Laughing or crying.

Once you have determined your child’s asthma triggers, have your child take steps to avoid them. Depending on your child’s triggers, you may be able to reduce the chance of an asthma attack by:

·         Keeping your home clean by dusting and vacuuming regularly. If possible, use a high-efficiency particulate arrestance (HEPA) vacuum.

·         Washing your child’s sheets weekly in hot water.

·         Using allergy-proof mattress covers and casings on your child’s bed.

·         Keeping pets out of your home or at least out of your child’s room.

·         Taking care of mold and water problems in your home.

·         Avoiding smoking in your home.

·         Avoiding having your child spend a lot of time outdoors when pollen counts are high and on very windy days.

·         Avoiding using strong perfumes or odor sprays.

Medicines

Give over-the-counter and prescription medicines only as told by your child’s health care provider. Many asthma attacks can be prevented by carefully following the prescribed medicine schedule. Giving medicines correctly is especially important when certain asthma triggers cannot be avoided. Even if your child seems to be doing well, do notstop giving your child the medicine and do notgive your child less medicine.

Monitor your child’s asthma

 

To monitor your child’s asthma:

·         Teach your child to use the peak flow meter every day and record the results in a journal. A drop in peak flow numbers on one or more days may mean that your child is starting to have an asthma attack, even if he or she is not having symptoms.

·         When your child has asthma symptoms, track them in a journal.

·         Note any changes in your child’s symptoms.

Act quickly

If an asthma attack happens, acting quickly can decrease how severe it is and how long it lasts. Take these actions:

·         Pay attention to your child’s symptoms. If he or she is coughing, wheezing, or having difficulty breathing, do notwait to see if the symptoms go away on their own. Follow the asthma action plan.

·         If you have followed the asthma action plan and the symptoms are not improving, call your child’s health care provider or seek immediate medical care at the nearest hospital.

It is important to note how often your child uses a fast-acting rescue inhaler. If it is used more often, it may mean that your child’s asthma is not under control. Adjusting the asthma treatment plan may help.

What are some ways I can protect my child from an asthma attack at school?

Make sure that your child’s teachers and the staff at school know that your child has asthma. Meet with them at the beginning of the school year and discuss ways that they can help your child avoid any known triggers. Common asthma triggers at school include:

·         Exercising, especially outdoors when the weather is cold.

·         Dust from chalk.

·         Animal dander from classroom pets.

·         Mold and dust.

·         Certain foods.

·         Stress and anxiety due to classroom or social activities.

What are some ways I can protect my child from an asthma attack during exercise?

Exercise is a common asthma trigger. To prevent asthma attacks during exercise, make sure that your child:

·         Uses a fast-acting inhaler 15 minutes before recess, sports practice, or gym class.

·         Drinks water throughout the day.

·         Warms up before any exercise.

·         Cools down after any exercise.

·         Avoids exercising outdoors in very cold or humid weather.

·         Avoids exercising outdoors when pollen counts are high.

·         Avoids exercising when sick.

·         Exercises indoors when possible.

·         Works gradually to get more physically fit.

·         Practices cross-training exercises.

·         Knows to stop exercising immediately if asthma symptoms start.

 

Encourage your child to participate in exercise that is less likely to trigger asthma symptoms, such as:

·         Indoor swimming.

·         Biking.

·         Walking.

·         Hiking.

·         Short distance track and field.

·         Football.

·         Baseball.

 

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